急性淋巴细胞白血病采用颅脑放疗和鞘内注射甲氨蝶呤治疗时中枢神经系统复发率较低。
Low incidence of CNS relapse with cranial radiotherapy and intrathecal methotrexate in acute lymphoblastic leukemia.
作者信息
Raje N S, Vaidya S J, Kapoor G, Pai S K, Nair C N, Kurkure P A, Magrath I T, Advani S H
机构信息
Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay.
出版信息
Indian Pediatr. 1996 Jul;33(7):556-60.
OBJECTIVES
To assess the incidence of isolated central nervous system (CNS) relapses in patients of acute lymphoblastic leukemia (ALL) treated with a protocol containing cranial irradiation and intrathecal methotrexate as CNS directed therapy.
DESIGN
Prospective non randomized study.
SETTING
Department of Medical Oncology, Tata Memorial Hospital.
SUBJECTS
623 children of ALL on MCP 841.
METHODS
CNS relapse was diagnosed, if upon examination of the CSF, more than 50 cells/microliter were observed, or a count of 5 cells which were unequivocally lymphoblasts.
RESULTS
The incidence of isolated CNS relapse was 1.75% with the use of this treatment. Age, sex, white blood cell count, platelet count, lactic dehydrogenase and immunophenotyping were not significantly related to isolated CNS relapse.
CONCLUSION
A low incidence of isolated CNS relapse demonstrates the adequacy of the presymptomatic CNS therapy.
目的
评估在采用包含颅脑照射和鞘内注射甲氨蝶呤作为中枢神经系统定向治疗方案治疗的急性淋巴细胞白血病（ALL）患者中孤立性中枢神经系统（CNS）复发的发生率。
设计
前瞻性非随机研究。
地点
塔塔纪念医院医学肿瘤学系。
研究对象
623例接受MCP 841方案治疗的ALL患儿。
方法
如果脑脊液检查发现每微升超过50个细胞，或明确为淋巴细胞母细胞的细胞计数为5个，则诊断为CNS复发。
结果
采用该治疗方法时，孤立性CNS复发的发生率为1.75%。年龄、性别、白细胞计数、血小板计数、乳酸脱氢酶和免疫表型与孤立性CNS复发无显著相关性。
结论
孤立性CNS复发的低发生率表明症状前CNS治疗是充分的。
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